EHR Exposé Shakes Up Industry
March 19, 2019 | Eric D. Fader | Electronic Health Records | False Claims Act | Fraud and Abuse | Hospitals | Legislation and Public Policy | Litigation | Medicare and Medicaid
A three-month joint investigation of electronic health records (EHR) systems has culminated in a release of a March 18 article in Kaiser Health News (KHN) and Fortune Magazine, “Death By 1,000 Clicks: Where Electronic Health Records Went Wrong.” The lengthy, meticulously sourced article calls EHR systems “an unholy mess.” KHN and Fortune have made the …
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Embryo Destruction Lawsuits Open New Legal Frontier
February 21, 2019 | Katherine A. Heptig | Cassandra Rivais | Litigation
As of January 2019, following a months-long break in the cases due to judicial transition, at least 70 lawsuits arising from the accidental destruction of human embryos and eggs were pending in Ohio state courts. The cases highlight the complex questions surrounding the legal status of embryos and, by consequence, theories of liability for the …
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Anti-Assignment Clause Bars Doctor’s Reimbursement Claim
February 20, 2019 | Rivkin Rounds Staff | Litigation | Private Insurers
Rivkin Radler’s Employee Benefit Plan Review included a summary of a case in which the U.S. Court of Appeals for the Eleventh Circuit held that an anti-assignment provision in a group health benefit plan barred direct reimbursement to an Atlanta dermatologist. The patient had executed an Assignment of Benefits in favor of the physician, a …
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FDA Issues Warning Letter on Unapproved Breast Implant Device
February 19, 2019 | Steven Shapiro | Litigation | Medical Devices and Wearables
Last week, the U.S. Food and Drug Administration (FDA) announced that it issued a warning letter to Mark Berman, M.D., a Beverly Hills, Calif., cosmetic surgeon, for illegally marketing an unapproved implantable device. Dr. Berman claims that the “Pocket Protector” can prevent and treat capsular contracture (tightening of scar tissue), a complication of breast implants. …
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HIPAA Still Applies to Patients’ Online Reviews of Providers
February 15, 2019 | Cassandra Rivais | Electronic Health Records | HIPAA | Litigation
In an era of online dialogue, healthcare providers still need to remain alert regarding their obligations under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). As tempting as it may be to respond to patients’ criticisms and praise online, healthcare providers, as “covered entities” under HIPAA, should think twice before clicking “post.” It’s …
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EHR Vendor to Pay $57 Million to Settle FCA Case
February 11, 2019 | Geoffrey R. Kaiser | Electronic Health Records | False Claims Act | Fraud and Abuse | Litigation | Medicare and Medicaid
On February 6, the U.S. Department of Justice announced that Greenway Health LLC, a Florida-based developer of electronic health records (EHR) software, will pay $57.25 million as part of a False Claims Act settlement. The United States had alleged that Greenway misrepresented the capabilities of its software product, called “Prime Suite,” causing healthcare providers to submit …
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Pathology Lab Company to Pay $63.5 Million to Settle FCA Case
February 5, 2019 | Christopher J. Kutner | Electronic Health Records | False Claims Act | Fraud and Abuse | Litigation | Medicare and Medicaid
Inform Diagnostics, a Texas-based pathology laboratory company, will pay the federal government $63.5 million to resolve allegations that the company violated the False Claims Act (FCA). The U.S. Department of Justice announced the settlement on January 30. Inform Diagnostics was alleged to have engaged in improper financial relationships with physicians, including providing them with subsidies …
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FTC to Focus on Unsubstantiated Health Claims
January 30, 2019 | Steven Shapiro | Fraud and Abuse | Litigation | Pharmaceuticals
On January 28, the Federal Trade Commission (FTC) published on its Business Blog a post titled “Hey Nineteen: Nine FTC developments that could impact your business in 2019.” Of most importance to the healthcare industry is the FTC’s promise to focus on unsubstantiated health claims in advertising. The relevant paragraph of the post reads as …
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Walgreens Pays $269.2 Million to Settle Fraud Allegations
January 24, 2019 | Geoffrey R. Kaiser | False Claims Act | Fraud and Abuse | Litigation | Medicare and Medicaid | Pharmaceuticals
Walgreens Boots Alliance, Inc., the operator of the Walgreens pharmacy chain, has agreed to pay $269.2 million in two settlements with the U.S. Department of Justice to resolve fraud allegations. The two cases arose from lawsuits filed by whistleblowers under the False Claims Act and were prosecuted federally by the U.S. Attorney’s Office for the Southern …
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Orthodontic Practice Pays $9 Million Settlement
January 23, 2019 | Eric D. Fader | Fraud and Abuse | Litigation | Medicare and Medicaid
On January 15, New York Attorney General Letitia James announced that Diamond Braces, an orthodontic practice with 10 offices in the State of New York, has settled charges that it allowed uncertified employees to perform orthodontic procedures and then improperly billed the Medicaid program for the procedures. The settlement included $4.5 million in restitution for …
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